Logistic回归和PLS-DA模型评价肿瘤标志物对结肠癌的诊断价值  

Diagnostic of serum tumor markers for colon cancer assessed with logistic regression analysis and PLS-DA model

作　　者：曾龙飞 田刚 姚健[1,3] 

机构地区：[1]西南医科大学附属医院肝胆外科,四川泸州646000 [2]西南医科大学附属医院检验科,四川泸州646000 [3]四川省泸州市人民医院肝胆外科,646000

出　　处：《重庆医学》2017年第8期1038-1041,共4页Chongqing medicine

基　　金：四川省教育厅重点项目(2005A076);四川省泸州市科技计划项目[2015-S-51(1/3)];西南医科大学自然科学基金(30543);西南医科大学附属医院人才基金资助项目(12277)

摘　　要：目的探讨血清肿瘤M2型丙酮酸激酶(TuM2-PK)、癌胚抗原(CEA)、糖类抗原CA199、CA724、CA125和CA242对结肠癌的诊断价值。方法采用酶联免疫吸附法(ELISA)和电化学发光法测定231例结肠癌、105例结肠良性病和166例健康对照血清TuM2-PK、CEA、CA199、CA724、CA125和CA242水平。采用ROC曲线和Logistic-ROC曲线比较单一和组合标志物的诊断效能,以最优组合标志物建立结肠癌Logistic回归和偏最小二乘判别分析(PLS-DA)诊断模型。结果结肠癌组血清TuM2-PK、CEA、CA199、CA125和CA242水平显著高于结肠良性病组和健康对照组(P<0.05)。血清CA199诊断结肠癌的ROC曲线下面积(AUC)最高[0.79(95%CI:0.75~0.83)],在临界值为69.5U/L时灵敏度和特异性分别为64.1%和89.7%。Logistic-ROC曲线中各组合标志物较单一指标的AUC高,其中(CEA+CA199+TuM2-PK)的AUC较为理想[0.89(95%CI:0.86~0.92)]。血清(CEA+CA199+TuM2-PK)的Logistic回归和PLS-DA模型对结肠癌的诊断准确率分别为82.7%和77.5%,对非结肠癌的诊断准确率分别为93.7%和95.6%。结论联合检测血清CEA、CA199和TuM2-PK是较为理想的肿瘤标志物组合,有助于结肠癌的早期诊断。Objective To investigate the diagnostic value of serum tumors M2 pyruvate kinase（TuM2-PK）,carcino-embryonic antigen（CEA）,CA199,CA724,CA125 and CA242in colon cancer.Methods Serum levels of TuM2-PK,CEA,CA199,CA724,CA125 and CA242in 231 patients with colon cancer,105 patients with colon benign lesion diseases and 166 normal controls were measured by the ELISA and electrochemiluminescence assays.The operation working characteristic curve（ROC）and the logistic regression-ROC were used to evaluate the diagnostic value of tumor markers for colon cancer individually and in combination.The models of logistic regression analysis and partial least-squares discriminant analysis（PLS-DA）were established to diagnose patients with colon cancer based on the optimal panel of serum tumor markers.Results Concentrations of serum TuM2-PK,CEA,CA199,CA125 and CA724in the colon cancer group are higher than those in the colon benign diseases group and the normal controls（P〈0.05）.The area under the operation working characteristic curve（AUC）of CA199 is the highest 0.79[95% confidence interval（95%CI）,0.75-0.83]at the cutoff value of 69.5U/L with 64.1% of sensitivity and 89.7% of specificity.The AUC of combined serum tumor markers based on logistic regression analysis is higher than those in individuals,of which serum（CEA＋CA199＋TuM2-PK）is the optimal[AUC=0.89,95% confidence interval（95%CI）,0.86-0.92].The diagnostic accuracy of logistic analysis and PLS-DA model for colon cancer is 82.7% and 77.5%,and for colon cancer is 93.7% and 95.6%,respectively.Conclusion The combination of serum tumor markers CEA,CA199 and TuM2-PK is more suitable as a diagnostic model for the screening of colon cancer.

关 键 词：结肠肿瘤 肿瘤M2型丙酮酸激酶 ROC曲线 LOGISTIC回归分析 

分 类 号：R735.35[医药卫生—肿瘤]